Infertility: Causes, Symptoms, Diagnosis, Treatment, and Prevention
A condition known as infertility affects the ability to conceive or carry a pregnancy to term. Infertility can affect both men and women, and it can have various causes and consequences. Infertility is usually defined as the inability of a woman to conceive after 12 months of regular unprotected sexual contact.
Causes
Infertility can be caused by factors that affect the reproductive system of either or both partners. Some common causes of infertility include:
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Ovulation disorders, such as polycystic ovary syndrome (PCOS), premature ovarian failure, or thyroid problems, that affect the production or release of eggs from the ovaries
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Tubal factors, such as pelvic inflammatory disease (PID), endometriosis, or previous surgery, that damage or block the fallopian tubes that carry the eggs to the uterus
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Uterine factors, such as fibroids, polyps, or congenital anomalies, that interfere with the implantation or development of the embryo in the uterus
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Male factors, such as low sperm count, poor sperm motility, or abnormal sperm shape, that reduce the quality or quantity of the sperm that can fertilize the egg
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Unexplained factors, when no specific cause can be identified after testing
Some possible risk factors for developing infertility include:
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Age, as fertility declines with advancing age, especially after 35 years old for women and 40 years old for men
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Lifestyle, such as smoking, alcohol, drugs, obesity, stress, or exposure to environmental toxins, that may affect the hormonal balance, ovulation, sperm production, or implantation
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Medical conditions, such as diabetes, cancer, or sexually transmitted infections (STIs), that may impair the function or damage the organs of the reproductive system
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Genetic factors, such as chromosomal abnormalities or inherited disorders, that may affect the quality or compatibility of the gametes or the embryo
Symptoms
A primary sign of infertility is the inability to conceive or maintain a pregnancy after trying for a year or more. However, some people experience other signs or symptoms that indicate a problem with their fertility, such as:
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Irregular, absent, or painful menstrual periods
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Abnormal vaginal bleeding or discharge
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Pelvic pain or discomfort
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Changes in sexual desire or function
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Breast changes or nipple discharge
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Erectile dysfunction or ejaculation problems
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Swelling or lumps in the testicles or scrotum
Diagnosis
Infertility can be diagnosed by a medical evaluation and testing of both partners. The evaluation may include:
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Medical history and physical examination
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Semen analysis to assess the sperm count, motility, and morphology
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Hormone tests to measure the levels of reproductive hormones, such as follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen, progesterone, testosterone, or thyroid hormones
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Ovulation tests to detect the surge of LH that indicates the release of an egg from the ovary
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Imaging tests, such as ultrasound, hysterosalpingography (HSG), or laparoscopy, to visualize the structures and function of the uterus, fallopian tubes, and ovaries
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Genetic tests to identify any chromosomal abnormalities or inherited disorders that may affect the fertility
Treatment
Treatment for infertility is determined by the cause, duration, and severity of the condition, as well as the couple's age, preferences, and overall health. As part of the treatment, the reproductive system is restored to normal function, the embryo is conceived and implanted, and the pregnancy and delivery are supported.
Some possible treatments for infertility include:
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Medications to stimulate the ovulation, improve the sperm quality, or correct the hormonal imbalance
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Surgery to repair or remove any structural abnormalities or blockages in the reproductive organs
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Assisted reproductive technologies (ART), such as in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or gamete intrafallopian transfer (GIFT), that involve the manipulation and transfer of the gametes or the embryo outside the body
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Donor eggs, sperm, or embryos, that are obtained from a third party and used for fertilization or implantation
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Surrogacy or gestational carrier, that involves another woman who carries and delivers the baby for the intended parents
Prevention
Infertility cannot be prevented in all cases, as some causes are unknown or unavoidable. However, some possible ways to reduce the risk or improve the chances of conceiving include:
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Having regular and timely sexual intercourse, especially during the fertile window, which is the 6 days before and including the day of ovulation
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Adopting a healthy lifestyle, such as quitting smoking, limiting alcohol, avoiding drugs, maintaining a normal weight, managing stress, and avoiding exposure to environmental toxins
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Seeking medical attention and treatment for any conditions or infections that may affect the fertility, such as diabetes, cancer, or STIs
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Having regular check-ups and screenings to monitor the reproductive health and detect any problems early
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Following the doctor’s advice and instructions regarding the use of medications, supplements, or contraceptives
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Exploring the available options and seeking professional help and support if infertility persists or affects the emotional well-being
With proper diagnosis, treatment, and care, most cases of infertility can be overcome and lead to a successful pregnancy and healthy baby.
